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Neuro-ophthalmology Illustrated Chapter 15 – Cavernous Sinus and Orbital Vascular Disorders 2

March 25, 2020 By

Questions:
11. When is treatment indicated for carotid-cavernous fistulas?
12. What are the findings of thrombosis of the cavernous sinus?
13. What is the usual cause of cavernous sinus thrombosis?
14. What should be considered in a patient with apparent orbital cellulitis?
15. What are the major risks of thrombosis of the cavernous sinus?
16. What are 3 very serious complications of cavernous sinus thrombosis?
17. What is the mnemonic for the structures and their position in the cavernous sinus?
18. What is the cause of “orbital varices”?
19. What should be considered when a crying infant eye bulges?

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Neuro-ophthalmology Illustrated Chapter 15 – Cavernous Sinus and Orbital Vascular Disorders 1

March 18, 2020 By

Questions:
1. What symptoms and signs may develop from an aneurysm of the internal carotid artery within the cavernous sinus?
2. What are the characteristics of direct shunts between the internal carotid artery and the cavernous sinus?
3. What are the characteristics of indirect carotid-cavernous or dural shunts?
4. Does a carotid-cavernous fistula have unilateral or bilateral ocular symptoms?
5. Do carotid-cavernous fistulas always have ocular symptoms?
6. What are 10 ocular findings of a carotid-cavernous fistula?
7. Which of the cranial nerves is most commonly affected by a carotid-cavernous fistula?
8. Can mechanical restriction of extraocular muscles occur with a carotid-cavernous fistula?
9. What diagnosis should be considered in an elderly woman with a mild headache, and elevated intraocular pressure?
10. What should be considered in all patients with a bruit accompanying a chronically red eye?

Neuro-ophthalmology Illustrated Chapter 14 – Orbital Syndromes

March 11, 2020 By

Questions:
1. What is an orbital syndrome?
2. What are the common features of the orbital syndromes?
3. What are 5 categories of acute or subacute orbital syndromes?
4. What is the most cause of unilateral or bilateral proptosis?
5. What should be suspected if there is proptosis with globe displacement?
6. What tumor is classically associated with fat atrophy and enophthalmos?
7. Why do patients with an orbital syndrome need to be evaluated urgently?
8. What imaging tests are appropriate for orbital syndromes?
9. Do brain CT and MRI scans often miss orbital processes?
10.Is orbital biopsy often necessary?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 13 – Localization of Findings & Treatment of Diplopia – Syndromes 

March 4, 2020 By

Questions:
169. What is the Raymond syndrome?
170. What is the Millard-Gubler syndrome?
171. What is the Foville syndrome?
172. What is the Wallenberg syndrome?
173. What is the Weber syndrome?
174. What is the Nothnagel syndrome?
175. What is Benedikt syndrome?
176. What is the Claude syndrome?
177. What is the top of the basilar syndrome?
178. What is the Tolosa-Hunt syndrome?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 13 – Localization of Findings & Treatment of Diplopia – 3rd and 4th Nerves

February 26, 2020 By

Questions:
161. Where do these findings localize the lesion: 4th nerve palsy with contralateral Horner syndrome?
162Where do these findings localize the lesion: 3rd nerve palsy with contralateral ptosis and contralateral superior rectus weakness?
163. Where do these findings localize the lesion: 3rd nerve palsy with contralateral hemiparesis?
164. Where do these findings localize the lesion: 3rd nerve palsy and ipsilateral cerebellar ataxia?
165. Where do these findings localize the lesion: 3rd nerve palsy and contralateral tremor?
166. Where do these findings localize the lesion: 3rd nerve palsy and contralateral ataxia with tremor?
167. Where do these findings localize the lesion: 3rd nerve palsy with vertical gaze palsy, lid retraction, skew deviation, and convergence nystagmus?
168. Where do these findings localize the lesion: 3rd nerve palsy with depressed mental status?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 13 – Localization of Findings & Treatment of Diplopia – 6th nerve

February 19, 2020 By

Questions:
156. Where do these findings localize the lesion: Horizontal gaze palsy with ipsilateral facial palsy?
157. Where do these findings localize the lesion: 6th nerve palsy with contralateral hemiparesis?
158. Where do these findings localize the lesion: 6th nerve palsy with ipsilateral 7th nerve palsy and contralateral hemiparesis?
159. Where do these findings localize the lesion: 6th nerve palsy with ipsilateral 7th nerve palsy, deafness, hypoesthesia, Horner syndrome, contralateral pain, thermal hypoesthesia, and ataxia?
160. Where do these findings localize the lesion: 6th nerve palsy with ipsilateral Horner syndrome?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 12 – Skew, Tilt, Whipple & Ocular Neuromyotonia

February 12, 2020 By

Questions:
143. What are 7 characteristics of Skew Deviation?
144. What test can help differentiate a 4th nerve palsy from skew deviation?
145. What is the ocular tilt reaction?
146. What transmission pathway is disrupted in skew deviation and the ocular tilt reaction?
147. What infectious condition can cause a vertical gaze palsy?
148. What is the cause of Whipple disease?
149. What are the findings of Whipple disease?
150. Where are saccadic eye movements initiated?
151. Where are smooth pursuit eye movements generated?
152. What is the function of inputs to the visual system from the vestibular nuclear complexes?
153. What is Ocular Neuromyotonia?
154. What are the symptoms of Ocular Neuromyotonia?
155.  What is the usual cause of Ocular Neuromyotonia?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 11 – Vertical Eye Movements

February 5, 2020 By

Questions:

135. Where are the critical supranuclear structures mediating vertical gaze located?
136. What are the 4 most important pretectal areas related to vertical eye movement?
137. Where are the burst neurons responsible for vertical saccades located?
138. What serves as the neural integrator for vertical gaze and torsion?
139. For downgaze, where do the axons from the interstitial nucleus of Cajal (INC) project?
140. What are the 4 findings of the Dorsal Midbrain Syndrome?
141. What are 2 other names for the Dorsal Midbrain Syndrome?
142. What is a common cause of the Dorsal Midbrain Syndrome?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 10 – Convergence, Divergence & Ocular Motor Apraxia

January 29, 2020 By

Questions:
125. What is congenital ocular motor apraxia?
126. What is convergence spasm?
127. What is the cause of convergence spasm?
128. What test will usually differentiate convergence spasm from a bilateral 6th nerve palsy?
129. What is convergence insufficiency?
130. How is convergence insufficiency treated?
131. What are causes of convergence insufficiency?
132. What is divergence insufficiency?
133. What causes divergence insufficiency?
134. What lesion location is likely in the presence of horizontal conjugate deviation of the eyes to one side?

Neuro-ophthalmology Illustrated Chapter 13 Diplopia 9 – Internuclear & Supranuclear Lesions

January 22, 2020 By

Questions:
115. A patient has a deficit of adduction of the one eye, nystagmus of the fellow abducting eye, skew deviation and the adduction deficit is overcome with convergence. What condition is present?
116. A patient has a deficit of adduction of the one eye, nystagmus of the fellow abducting eye, skew deviation and the adduction deficit is overcome with convergence. Where is the lesion?
117. What are 4 findings of a unilateral internuclear ophthalmoplegia?
118. A patient has a deficit of adduction of both eyes, nystagmus of the fellow abducting eye, exotropia, and loss of convergence. What condition is present?
119. Where is the lesion located in wall-eyed bilateral internuclear ophthalmoplegia (WEBINO)?
120. A patient has the following findings: a gaze palsy to one side, and on attempted gaze to the opposite side impaired adduction and nystagmus of the abducting eye. In addition, the patient has a facial palsy on the side with the gaze palsy. What syndrome is present?
121. Where is the lesion in the One-and-a-Half Syndrome?
122. What are 2 common causes of isolated internuclear ophthalmoplegia?
123. What conditions may mimic an isolated internuclear ophthalmoplegia?
124. What conditions may mimic the one-and-a-half syndrome?